A unique presentation of pheochromocytoma: Exploring transient diabetes through case analysis and an in-depth literature review

Pheochromocytomas are catecholamine-secreting tumors frequently presenting with the classic triad of paroxysmal hypertension, headache, and sweating. Interestingly, patients with pheochromocytoma may also experience varying degrees of dysglycemia. This case report highlights the atypical presentation of pheochromocytoma in a young patient who initially exhibited insulin-dependent diabetes that was misdiagnosed as type 1 diabetes. We report a 27-year-old Ethiopian patient initially misdiagnosed with type 1 diabetes after presenting with new-onset hyperglycemia requiring insulin therapy. Six months later, the patient developed hypertension, palpitations, and right flank pain. Adrenal pheochromocytoma was diagnosed based on significantly elevated 24-hour urinary fractionated metanephrines and a 4.85 cm right adrenal mass detected on imaging. Following right cortical-sparing open adrenalectomy, the patient’s blood pressure normalized, and insulin therapy was discontinued. The patient maintained normoglycemia over a 15-month follow-up with no signs of clinical or biochemical abnormalities recurrence. This case highlights a rare presentation of pheochromocytoma masquerading as insulin-requiring diabetes. Pheochromocytomas can cause various degrees of dysglycemia due to impaired insulin secretion and peripheral resistance